Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2012
Multicenter Study Comparative StudyPrediction of early stroke recurrence in transient ischemic attack patients from the PROMAPA study: a comparison of prognostic risk scores.
Several clinical scales have been developed for predicting stroke recurrence. These clinical scores could be extremely useful to guide triage decisions. Our goal was to compare the very early predictive accuracy of the most relevant clinical scores [age, blood pressure, clinical features and duration of symptoms (ABCD) score, ABCD and diabetes (ABCD2) score, ABCD and brain infarction on imaging score, ABCD2 and brain infarction on imaging score, ABCD and prior TIA within 1 week of the index event (ABCD3) score, California Risk Score, Essen Stroke Risk Score and Stroke Prognosis Instrument II] in consecutive transient ischemic attack (TIA) patients. ⋯ All published scores that do not take into account vascular imaging or prior TIA when identifying stroke risk after TIA failed to predict risk when applied by neurologists. Clinical scores were not able to replace extensive emergent diagnostic evaluations such as vascular imaging, and they should take into account unstable patients with recent prior transient episodes.
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Cerebrovascular diseases · Jan 2012
Meta AnalysisApolipoprotein A5 gene promoter region-1131T/C polymorphism is associated with risk of ischemic stroke and elevated triglyceride levels: a meta-analysis.
The association between polymorphism -1131T/C in the promoter region of apolipoprotein A5 (APOA5) and ischemic stroke and plasma triglyceride (TG) levels remains controversial. To better clarify the association between APOA5-1131T/C and risk of ischemic stroke and plasma TG levels, we performed a meta-analysis to examine the allele and genotype of APOA5-1131T/C polymorphism in ischemic stroke cases and controls. ⋯ Our meta-analysis revealed that the APOA5-1131T/C polymorphism is associated with a significant risk of ischemic stroke and elevated TG levels. The CC genotype and C allele might be a genetic risk factor that increases susceptibility of ischemic stroke and elevates plasma TG levels, and might be a useful target for clinical therapeutic intervention.
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Cerebrovascular diseases · Jan 2012
Multicenter Study Comparative StudyThe disparity in long-term survival after a first stroke in patients with and without diabetes persists: the Northern Sweden MONICA study.
Diabetes is an established risk factor for stroke. Compared to nondiabetic patients, diabetic patients also have an increased risk of new vascular events and death after stroke. We analyzed how differences in long-term survival between diabetic and nondiabetic stroke patients have changed over time, and if differences varied with respect to sex and age. ⋯ Long-term survival after a first stroke has improved in both diabetic and nondiabetic patients. Survival is markedly lower in diabetics, especially in women and younger patients, and the disparity persisted over 24 years. Decreasing the disparity in stroke survival is a challenge for stroke and diabetes care. New treatment methods in combination with intense secondary prevention in diabetic patients, especially in younger women, are needed.
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Cerebrovascular diseases · Jan 2012
Diffusion tensor imaging predicts long-term motor functional outcome in patients with acute supratentorial intracranial hemorrhage.
It remains unclear how wallerian degeneration of the pyramidal tract (PT) in the acute phase of supratentorial intracranial hemorrhage (ICH) correlates with the long-term functional outcome. The aim of this study was to quantify and predict the long-term neuromotor outcome using diffusion tensor imaging (DTI) during the early stages of ICH. ⋯ This study demonstrated that the use of DTI during the early stages of ICH may predict motor outcomes at 6 months after ICH. Moreover, as compared to use of DTI within 3 days of ICH onset, the application of DTI at 2 weeks after ICH could more accurately predict the motor outcomes and daily living activities of patients.
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Cerebrovascular diseases · Jan 2012
Multicenter StudyEffect of serum lipid levels on stroke outcome after rt-PA therapy: SAMURAI rt-PA registry.
The effects of lipid levels on clinical outcomes after ischemic stroke are controversial. Whether admission lipid levels and prior statin use are associated with early intracerebral hemorrhage (ICH) and long-term functional outcome after recombinant tissue plasminogen activator (rt-PA) therapy for stroke patients was investigated. ⋯ The admission HDL-C level was associated with favorable outcome 3 months after intravenous rt-PA therapy in stroke patients without cardioembolism.